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An Alternative Projection From a Study of Large, Prepaid Group Practices

Robert Mulhausen, MD; Jeanne McGee, PhD

JAMA. 1989;261(13):1930-1934.

Abstract
To model a base level of physician demand in a managed health care system, we examined in 1983 the ratios by specialty of full-time equivalent physicians to health maintenance organization members in seven large, closed-panel health maintenance organizations, each with more than 100 000 members. The medical director of each plan was surveyed by mailed questionnaire and telephone interview to determine the plan's number of full-time equivalent physicians by specialty and members served. Out-of-plan physicians contracted by the group were included within the specialty distribution wherever possible. We compared our findings (4779.4 full-time equivalent physicians serving 4 297 790 members) with Graduate Medical Education National Advisory Committee and others' projections of physician need and supply. Based on this model and unknowns that might affect utilization, our study suggests that at least 111 physicians per 100 000 population would be necessary in a system that emphasized reduced utilization of services and that more primary care physicians would be needed than the Graduate Medical Education National Advisory Committee predicted would be available.

(JAMA. 1989;261:1930-1934)

Author Affiliations
From Interstudy, Excelsior, Minn (Drs Mulhausen and McGee); Department of Medicine, St Paul—Ramsey Medical Center, St Paul, Minn (Dr Mulhausen); and University of Minnesota Medical School and School of Public Health, Minneapolis (Dr Mulhausen). Dr McGee is currently president of Research Insights, Inc, Excelsior, Minn.

Footnotes
Reprint requests to Department of Internal Medicine, St Paul—Ramsey Medical Center, 640 Jackson St, St Paul, MN 55101 (Dr Mulhausen).

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